It may come as a surprise to physicians who are highly regarded by their colleagues that their recognized professional expertise is merely one of seven components that garner the highest praise and confidence of their patients. These other traits — including being accessible, personable, and good communicators — complete the portrait of physicians rated “best in class” by patients who feel supported and empowered by a kind of partnership that may in fact enable them to receive the best possible care.
This was the upshot of a recent survey conducted by DrScore, a free, publicly available patient satisfaction Web site that collects anonymous patient ratings of U.S. primary care physicians. The survey sought to learn more about the specific qualities that patients note and value, using information from open comments provided by patients describing their satisfaction with their doctors.
Methods
Qualitative data on patient satisfaction and preferences for health care were obtained from structured comment fields provided by respondents who completed an online patient satisfaction survey at DrScore.com.
The survey asked patients to rate their physician on several dimensions of health care experiences, as well as to provide specific comments both about aspects of care that were most excellent and those that could be improved. Of 5,030 completed surveys, some 2,917 (58%) respondents provided comments relating to their healthcare experiences and rated the physician or practice. These data were then qualified to determine specific traits. For more information on how the data were analyzed, see “Qualifying the Data.”
Results
A total of 24 nodes or specific traits were identified from the coding of the patient comments. Among the 24 nodes, seven thematic clusters, or domains, of excellent healthcare quality valued by patients were identified.
They included excellence in the following categories:
1. access to physician or healthcare services
2. communication with and by provider
3. personality and demeanor of provider, such as being supportive, caring, and compassionate
4. quality of medical care processes such as diagnosis and treatment;
5. continuity of care when following up on health care issues or concerns, making referrals and discussing test results
6. quality of the healthcare facilities
7. quality of office staff.
Quality 1: Outstanding Access
The ability to see their doctor on relatively short notice without having to endure excessively long wait times in the office was under this heading, as was having telephone calls returned quickly and reliably to enable patients to seek advice or clarifications regarding their health care or treatment over the phone. Beyond being responsive to their calls, patients recognized their doctors’ excellence in use of the telephone to personally check on their progress and well-being.
Quality 2: Outstanding Communication Skills
This category received the second largest volume of comments, with patients distinguishing the four key areas discussed below related to communication that defined high-quality care, summarized as “personal attention” given by the provider.
Listening — Patients value providers who are excellent listeners, and who take patients’ concerns seriously. These qualities convey truly caring about their patients as individuals and their concerns as well as those of their family members. Patients clearly felt better cared for by physicians they considered to be attentive listeners than those not perceived as such.
Treating the patient as a partner — Another quality of excellence is that ability to instill a sense of partnership with the patient both by encouraging patients to openly discuss concerns and by considering the patient’s concerns or values too and to adjust and individualize treatment accordingly.
Providing information — Much information, often technical in nature, is exchanged in a clinical care encounter, and providers who do this well in a manner that the patient can understand are highly praised by their patients as being approachable and easy to talk to.
Manner of communication — It seems too that the tone of the communication delivery makes a difference to patients. The physician qualities they admired in this realm included being soft spoken and direct and giving opinions honestly in a warm conversational style.
Quality 3: Outstanding Personality and Demeanor
This category encompasses aspects of the provider’s demeanor and personality –—beyond communications skills noted above — that patients valued. Patients consider their interactions with their physician or group practice, not as a business relationship but a personal one in which they gravitate to qualities such as warmth and sincerity. In a sense, patients who are extremely satisfied with their care feel “bonded” to providers they like and feel comfortable with. The five categories related to the warm personal qualities they value include: friendliness, which needs no explanation, as well as the remaining four discussed below.
1. Humaneness and caring. This is a quality of clear outward expression by the provider that he/she truly cares about the patient to the level of being perceived as sincere and compassionate about their needs and those of their families.
2. Supportive and Understanding. This quality encompasses patience, consideration, and apparent empathy in physicians who seem to put their patients’ interests first and strive to support their treatment choices.
3. Trust. As patients seek guidance from the physicians to whom they entrust their health and welfare, trust an essential quality that is based on patients’ belief that their physician is knowledgeable and sincere, and serving their interests first.
4. Family/Child. Another quality of provider excellence offered by patients is the appropriate inclusion of family members in health concerns, projecting a family-focused sensibility that reflects competence in dealing with adults and children.
Quality 4: Outstanding Medical Care
Receiving excellent medical care is highly valued and consists of a complex of qualities, including patient advocacy as well as technical competence related to diagnosis/treatment approaches and options, thoroughness, amount of time spent with patient, and use of medications.
Patient Advocacy. This is essentially the extent to which patients perceive that their doctor is placing their interests first and promotes this interest to others.
Technical Competence. Among all categories, patients showered the most praise for their doctors’ excellence in competence covering facets of treatment approaches and outcomes. This finding emphasizes the reality that patients do in fact consider the skill of their practitioner to be crucial in their choice of physician for an office visit, procedure, or facet of healthcare management.
Thoroughness. Patients place high value on receiving careful attention from their physician, and not feeling rushed through their visits. When their physician spends time with them, patients feel listened to and that they are receiving thorough care.
Medications and Alternative Treatments. Contrary to the popular impression that patients visit physicians primarily to receive medication, patients who commended their physicians valued cautious use of medicine. They appreciated physician attention to informing them about their medications, finding ways to lower medication costs, following up to determine that prescribed medications are safe and effective, and making it easy to get refills.
As for alternative treatments, patients were impressed when their physicians were willing to “think outside the box” and “treat the whole person,” even offering assistance in researching nutritional supplements and alternative treatment options.
Quality 5: Outstanding Follow-up, Referrals and Care Continuity
While physicians may regard patient visits as discrete units, patients perceive an ongoing relationship with a practice and provider and value continuity of care that supports the patient’s need for problem resolution, treatment tailoring, and self-care management. In keeping with these needs, they praised providers who monitor and follow the path of future care, including offering referrals, second opinions when needed, and generally monitoring their patients’ health conditions.
Quality 6: Outstanding Office Staff
As an extension of the qualities valued in the physicians themselves, patients noticed the things that office staff did to enhance a positive experience encountered in a practice. Staff member qualities such as being professional, friendly, and helpful were offered as exemplary of highly rated practices.
Quality 7: Outstanding Facilities
The final component of excellent health care by patients surveyed was treatment in a convenient, clean, well-organized and modern facility. A comfortable attractive physical environment, perhaps including amenities such as soft drinks, apparently convey a patient-oriented atmosphere that patients notice and appreciate while awaiting their appointments.
Summary of Findings
The qualitative content in this study revealed that patients perceive and value at least seven domains of health care in defining excellent quality. Within each domain were content categories that further revealed the range of issues that matter.
By reviewing these results, we can gain a profile of the excellent doctor from the patient’s point of view. Perhaps the results are not all that startling if we reflect upon our own experience with care.
Patients value providers who take time to listen to them, work with them, support them in managing their health care, and who make an effort to personalize patient care.
Providers who work hard on the patient’s behalf are highly thought of, and earn the trust of their patients. These results also underscore the complexity of providing excellent health care.
Patients want to be informed, to be treated conservatively, to have help navigating the myriad of options and services that are available, and to get effective care.
Implications of Findings
Much of the content that appears here is focused on communication and interpersonal style, which generated more response content than more objective categories such as wait items and facility. However, U.S. physicians are trained primarily in the biomedical model. In addition to 4 years of college, physicians will typically complete 4 years of medical school, and 3 to 7 years (or more) of residency training. This is followed by a lifelong commitment to continuing medical education. It is not surprising that the quality of physicians’ technical skills are generally outstanding. Nevertheless, while patients value technical expertise, their overall health care experience is driven largely by other factors.
Healthcare consumers perceive excellence in health care largely as they do excellence in other consumer areas — valuing access, clean facilities, and personal attention.2 Thus, a practical use of these findings would be to emphasize them during physician training — focusing on developing skills that can result in clear communication, expressing empathy, and supporting patient information needs and desire for continuity of care. These qualities are likely to lead to clinical benefits including patients who are more compliant and who feel more empowered to achieve health promotion and disease prevention goals.
Quantitative Analysis
In considering the results of this study, a notable strength is the large number of patient comments that were provided and the use of a robust qualitative analysis tool that made apparent the emerging content clusters. It should be noted that qualitative analysis is designed to identify the core content areas and range of beliefs or attitudes associated with a topic rather than estimating the proportion of respondents with a certain view.
It may come as a surprise to physicians who are highly regarded by their colleagues that their recognized professional expertise is merely one of seven components that garner the highest praise and confidence of their patients. These other traits — including being accessible, personable, and good communicators — complete the portrait of physicians rated “best in class” by patients who feel supported and empowered by a kind of partnership that may in fact enable them to receive the best possible care.
This was the upshot of a recent survey conducted by DrScore, a free, publicly available patient satisfaction Web site that collects anonymous patient ratings of U.S. primary care physicians. The survey sought to learn more about the specific qualities that patients note and value, using information from open comments provided by patients describing their satisfaction with their doctors.
Methods
Qualitative data on patient satisfaction and preferences for health care were obtained from structured comment fields provided by respondents who completed an online patient satisfaction survey at DrScore.com.
The survey asked patients to rate their physician on several dimensions of health care experiences, as well as to provide specific comments both about aspects of care that were most excellent and those that could be improved. Of 5,030 completed surveys, some 2,917 (58%) respondents provided comments relating to their healthcare experiences and rated the physician or practice. These data were then qualified to determine specific traits. For more information on how the data were analyzed, see “Qualifying the Data.”
Results
A total of 24 nodes or specific traits were identified from the coding of the patient comments. Among the 24 nodes, seven thematic clusters, or domains, of excellent healthcare quality valued by patients were identified.
They included excellence in the following categories:
1. access to physician or healthcare services
2. communication with and by provider
3. personality and demeanor of provider, such as being supportive, caring, and compassionate
4. quality of medical care processes such as diagnosis and treatment;
5. continuity of care when following up on health care issues or concerns, making referrals and discussing test results
6. quality of the healthcare facilities
7. quality of office staff.
Quality 1: Outstanding Access
The ability to see their doctor on relatively short notice without having to endure excessively long wait times in the office was under this heading, as was having telephone calls returned quickly and reliably to enable patients to seek advice or clarifications regarding their health care or treatment over the phone. Beyond being responsive to their calls, patients recognized their doctors’ excellence in use of the telephone to personally check on their progress and well-being.
Quality 2: Outstanding Communication Skills
This category received the second largest volume of comments, with patients distinguishing the four key areas discussed below related to communication that defined high-quality care, summarized as “personal attention” given by the provider.
Listening — Patients value providers who are excellent listeners, and who take patients’ concerns seriously. These qualities convey truly caring about their patients as individuals and their concerns as well as those of their family members. Patients clearly felt better cared for by physicians they considered to be attentive listeners than those not perceived as such.
Treating the patient as a partner — Another quality of excellence is that ability to instill a sense of partnership with the patient both by encouraging patients to openly discuss concerns and by considering the patient’s concerns or values too and to adjust and individualize treatment accordingly.
Providing information — Much information, often technical in nature, is exchanged in a clinical care encounter, and providers who do this well in a manner that the patient can understand are highly praised by their patients as being approachable and easy to talk to.
Manner of communication — It seems too that the tone of the communication delivery makes a difference to patients. The physician qualities they admired in this realm included being soft spoken and direct and giving opinions honestly in a warm conversational style.
Quality 3: Outstanding Personality and Demeanor
This category encompasses aspects of the provider’s demeanor and personality –—beyond communications skills noted above — that patients valued. Patients consider their interactions with their physician or group practice, not as a business relationship but a personal one in which they gravitate to qualities such as warmth and sincerity. In a sense, patients who are extremely satisfied with their care feel “bonded” to providers they like and feel comfortable with. The five categories related to the warm personal qualities they value include: friendliness, which needs no explanation, as well as the remaining four discussed below.
1. Humaneness and caring. This is a quality of clear outward expression by the provider that he/she truly cares about the patient to the level of being perceived as sincere and compassionate about their needs and those of their families.
2. Supportive and Understanding. This quality encompasses patience, consideration, and apparent empathy in physicians who seem to put their patients’ interests first and strive to support their treatment choices.
3. Trust. As patients seek guidance from the physicians to whom they entrust their health and welfare, trust an essential quality that is based on patients’ belief that their physician is knowledgeable and sincere, and serving their interests first.
4. Family/Child. Another quality of provider excellence offered by patients is the appropriate inclusion of family members in health concerns, projecting a family-focused sensibility that reflects competence in dealing with adults and children.
Quality 4: Outstanding Medical Care
Receiving excellent medical care is highly valued and consists of a complex of qualities, including patient advocacy as well as technical competence related to diagnosis/treatment approaches and options, thoroughness, amount of time spent with patient, and use of medications.
Patient Advocacy. This is essentially the extent to which patients perceive that their doctor is placing their interests first and promotes this interest to others.
Technical Competence. Among all categories, patients showered the most praise for their doctors’ excellence in competence covering facets of treatment approaches and outcomes. This finding emphasizes the reality that patients do in fact consider the skill of their practitioner to be crucial in their choice of physician for an office visit, procedure, or facet of healthcare management.
Thoroughness. Patients place high value on receiving careful attention from their physician, and not feeling rushed through their visits. When their physician spends time with them, patients feel listened to and that they are receiving thorough care.
Medications and Alternative Treatments. Contrary to the popular impression that patients visit physicians primarily to receive medication, patients who commended their physicians valued cautious use of medicine. They appreciated physician attention to informing them about their medications, finding ways to lower medication costs, following up to determine that prescribed medications are safe and effective, and making it easy to get refills.
As for alternative treatments, patients were impressed when their physicians were willing to “think outside the box” and “treat the whole person,” even offering assistance in researching nutritional supplements and alternative treatment options.
Quality 5: Outstanding Follow-up, Referrals and Care Continuity
While physicians may regard patient visits as discrete units, patients perceive an ongoing relationship with a practice and provider and value continuity of care that supports the patient’s need for problem resolution, treatment tailoring, and self-care management. In keeping with these needs, they praised providers who monitor and follow the path of future care, including offering referrals, second opinions when needed, and generally monitoring their patients’ health conditions.
Quality 6: Outstanding Office Staff
As an extension of the qualities valued in the physicians themselves, patients noticed the things that office staff did to enhance a positive experience encountered in a practice. Staff member qualities such as being professional, friendly, and helpful were offered as exemplary of highly rated practices.
Quality 7: Outstanding Facilities
The final component of excellent health care by patients surveyed was treatment in a convenient, clean, well-organized and modern facility. A comfortable attractive physical environment, perhaps including amenities such as soft drinks, apparently convey a patient-oriented atmosphere that patients notice and appreciate while awaiting their appointments.
Summary of Findings
The qualitative content in this study revealed that patients perceive and value at least seven domains of health care in defining excellent quality. Within each domain were content categories that further revealed the range of issues that matter.
By reviewing these results, we can gain a profile of the excellent doctor from the patient’s point of view. Perhaps the results are not all that startling if we reflect upon our own experience with care.
Patients value providers who take time to listen to them, work with them, support them in managing their health care, and who make an effort to personalize patient care.
Providers who work hard on the patient’s behalf are highly thought of, and earn the trust of their patients. These results also underscore the complexity of providing excellent health care.
Patients want to be informed, to be treated conservatively, to have help navigating the myriad of options and services that are available, and to get effective care.
Implications of Findings
Much of the content that appears here is focused on communication and interpersonal style, which generated more response content than more objective categories such as wait items and facility. However, U.S. physicians are trained primarily in the biomedical model. In addition to 4 years of college, physicians will typically complete 4 years of medical school, and 3 to 7 years (or more) of residency training. This is followed by a lifelong commitment to continuing medical education. It is not surprising that the quality of physicians’ technical skills are generally outstanding. Nevertheless, while patients value technical expertise, their overall health care experience is driven largely by other factors.
Healthcare consumers perceive excellence in health care largely as they do excellence in other consumer areas — valuing access, clean facilities, and personal attention.2 Thus, a practical use of these findings would be to emphasize them during physician training — focusing on developing skills that can result in clear communication, expressing empathy, and supporting patient information needs and desire for continuity of care. These qualities are likely to lead to clinical benefits including patients who are more compliant and who feel more empowered to achieve health promotion and disease prevention goals.
Quantitative Analysis
In considering the results of this study, a notable strength is the large number of patient comments that were provided and the use of a robust qualitative analysis tool that made apparent the emerging content clusters. It should be noted that qualitative analysis is designed to identify the core content areas and range of beliefs or attitudes associated with a topic rather than estimating the proportion of respondents with a certain view.
It may come as a surprise to physicians who are highly regarded by their colleagues that their recognized professional expertise is merely one of seven components that garner the highest praise and confidence of their patients. These other traits — including being accessible, personable, and good communicators — complete the portrait of physicians rated “best in class” by patients who feel supported and empowered by a kind of partnership that may in fact enable them to receive the best possible care.
This was the upshot of a recent survey conducted by DrScore, a free, publicly available patient satisfaction Web site that collects anonymous patient ratings of U.S. primary care physicians. The survey sought to learn more about the specific qualities that patients note and value, using information from open comments provided by patients describing their satisfaction with their doctors.
Methods
Qualitative data on patient satisfaction and preferences for health care were obtained from structured comment fields provided by respondents who completed an online patient satisfaction survey at DrScore.com.
The survey asked patients to rate their physician on several dimensions of health care experiences, as well as to provide specific comments both about aspects of care that were most excellent and those that could be improved. Of 5,030 completed surveys, some 2,917 (58%) respondents provided comments relating to their healthcare experiences and rated the physician or practice. These data were then qualified to determine specific traits. For more information on how the data were analyzed, see “Qualifying the Data.”
Results
A total of 24 nodes or specific traits were identified from the coding of the patient comments. Among the 24 nodes, seven thematic clusters, or domains, of excellent healthcare quality valued by patients were identified.
They included excellence in the following categories:
1. access to physician or healthcare services
2. communication with and by provider
3. personality and demeanor of provider, such as being supportive, caring, and compassionate
4. quality of medical care processes such as diagnosis and treatment;
5. continuity of care when following up on health care issues or concerns, making referrals and discussing test results
6. quality of the healthcare facilities
7. quality of office staff.
Quality 1: Outstanding Access
The ability to see their doctor on relatively short notice without having to endure excessively long wait times in the office was under this heading, as was having telephone calls returned quickly and reliably to enable patients to seek advice or clarifications regarding their health care or treatment over the phone. Beyond being responsive to their calls, patients recognized their doctors’ excellence in use of the telephone to personally check on their progress and well-being.
Quality 2: Outstanding Communication Skills
This category received the second largest volume of comments, with patients distinguishing the four key areas discussed below related to communication that defined high-quality care, summarized as “personal attention” given by the provider.
Listening — Patients value providers who are excellent listeners, and who take patients’ concerns seriously. These qualities convey truly caring about their patients as individuals and their concerns as well as those of their family members. Patients clearly felt better cared for by physicians they considered to be attentive listeners than those not perceived as such.
Treating the patient as a partner — Another quality of excellence is that ability to instill a sense of partnership with the patient both by encouraging patients to openly discuss concerns and by considering the patient’s concerns or values too and to adjust and individualize treatment accordingly.
Providing information — Much information, often technical in nature, is exchanged in a clinical care encounter, and providers who do this well in a manner that the patient can understand are highly praised by their patients as being approachable and easy to talk to.
Manner of communication — It seems too that the tone of the communication delivery makes a difference to patients. The physician qualities they admired in this realm included being soft spoken and direct and giving opinions honestly in a warm conversational style.
Quality 3: Outstanding Personality and Demeanor
This category encompasses aspects of the provider’s demeanor and personality –—beyond communications skills noted above — that patients valued. Patients consider their interactions with their physician or group practice, not as a business relationship but a personal one in which they gravitate to qualities such as warmth and sincerity. In a sense, patients who are extremely satisfied with their care feel “bonded” to providers they like and feel comfortable with. The five categories related to the warm personal qualities they value include: friendliness, which needs no explanation, as well as the remaining four discussed below.
1. Humaneness and caring. This is a quality of clear outward expression by the provider that he/she truly cares about the patient to the level of being perceived as sincere and compassionate about their needs and those of their families.
2. Supportive and Understanding. This quality encompasses patience, consideration, and apparent empathy in physicians who seem to put their patients’ interests first and strive to support their treatment choices.
3. Trust. As patients seek guidance from the physicians to whom they entrust their health and welfare, trust an essential quality that is based on patients’ belief that their physician is knowledgeable and sincere, and serving their interests first.
4. Family/Child. Another quality of provider excellence offered by patients is the appropriate inclusion of family members in health concerns, projecting a family-focused sensibility that reflects competence in dealing with adults and children.
Quality 4: Outstanding Medical Care
Receiving excellent medical care is highly valued and consists of a complex of qualities, including patient advocacy as well as technical competence related to diagnosis/treatment approaches and options, thoroughness, amount of time spent with patient, and use of medications.
Patient Advocacy. This is essentially the extent to which patients perceive that their doctor is placing their interests first and promotes this interest to others.
Technical Competence. Among all categories, patients showered the most praise for their doctors’ excellence in competence covering facets of treatment approaches and outcomes. This finding emphasizes the reality that patients do in fact consider the skill of their practitioner to be crucial in their choice of physician for an office visit, procedure, or facet of healthcare management.
Thoroughness. Patients place high value on receiving careful attention from their physician, and not feeling rushed through their visits. When their physician spends time with them, patients feel listened to and that they are receiving thorough care.
Medications and Alternative Treatments. Contrary to the popular impression that patients visit physicians primarily to receive medication, patients who commended their physicians valued cautious use of medicine. They appreciated physician attention to informing them about their medications, finding ways to lower medication costs, following up to determine that prescribed medications are safe and effective, and making it easy to get refills.
As for alternative treatments, patients were impressed when their physicians were willing to “think outside the box” and “treat the whole person,” even offering assistance in researching nutritional supplements and alternative treatment options.
Quality 5: Outstanding Follow-up, Referrals and Care Continuity
While physicians may regard patient visits as discrete units, patients perceive an ongoing relationship with a practice and provider and value continuity of care that supports the patient’s need for problem resolution, treatment tailoring, and self-care management. In keeping with these needs, they praised providers who monitor and follow the path of future care, including offering referrals, second opinions when needed, and generally monitoring their patients’ health conditions.
Quality 6: Outstanding Office Staff
As an extension of the qualities valued in the physicians themselves, patients noticed the things that office staff did to enhance a positive experience encountered in a practice. Staff member qualities such as being professional, friendly, and helpful were offered as exemplary of highly rated practices.
Quality 7: Outstanding Facilities
The final component of excellent health care by patients surveyed was treatment in a convenient, clean, well-organized and modern facility. A comfortable attractive physical environment, perhaps including amenities such as soft drinks, apparently convey a patient-oriented atmosphere that patients notice and appreciate while awaiting their appointments.
Summary of Findings
The qualitative content in this study revealed that patients perceive and value at least seven domains of health care in defining excellent quality. Within each domain were content categories that further revealed the range of issues that matter.
By reviewing these results, we can gain a profile of the excellent doctor from the patient’s point of view. Perhaps the results are not all that startling if we reflect upon our own experience with care.
Patients value providers who take time to listen to them, work with them, support them in managing their health care, and who make an effort to personalize patient care.
Providers who work hard on the patient’s behalf are highly thought of, and earn the trust of their patients. These results also underscore the complexity of providing excellent health care.
Patients want to be informed, to be treated conservatively, to have help navigating the myriad of options and services that are available, and to get effective care.
Implications of Findings
Much of the content that appears here is focused on communication and interpersonal style, which generated more response content than more objective categories such as wait items and facility. However, U.S. physicians are trained primarily in the biomedical model. In addition to 4 years of college, physicians will typically complete 4 years of medical school, and 3 to 7 years (or more) of residency training. This is followed by a lifelong commitment to continuing medical education. It is not surprising that the quality of physicians’ technical skills are generally outstanding. Nevertheless, while patients value technical expertise, their overall health care experience is driven largely by other factors.
Healthcare consumers perceive excellence in health care largely as they do excellence in other consumer areas — valuing access, clean facilities, and personal attention.2 Thus, a practical use of these findings would be to emphasize them during physician training — focusing on developing skills that can result in clear communication, expressing empathy, and supporting patient information needs and desire for continuity of care. These qualities are likely to lead to clinical benefits including patients who are more compliant and who feel more empowered to achieve health promotion and disease prevention goals.
Quantitative Analysis
In considering the results of this study, a notable strength is the large number of patient comments that were provided and the use of a robust qualitative analysis tool that made apparent the emerging content clusters. It should be noted that qualitative analysis is designed to identify the core content areas and range of beliefs or attitudes associated with a topic rather than estimating the proportion of respondents with a certain view.
